Jejunoileal atresia and associated malformations: Correlation with the timing of in utero insult

Mesenteric Cyst in Association with Type-II Jejunoileal Atresia

“…6; 2017 seen in patients with volvulus, intussusceptions, internal hernia, and tight anterior abdominal wall defects. [3,6] As in our case, mesenteric cyst causing secondary bowel volvulus distally could be the causative factor for the vascular compromise leading to JIA.…”

“…It can also coexist with other anomalies like biliary atresia, duodenal atresia, colonic atresia, gastric atresia and Hirschsprung's disease. [2][3][4] The association of mesenteric cyst with JIA is extremely rare with less than 10 cases reported so far in literature. [5] Intrauterine mesenteric vascular disruptions to a segment of developed intestine seemed to result in JIA.…”

Placental vascular compromise in jejunoileal atresia

“…Some jejunal atresias may be commonly complicated with other anomalies, suggesting the result of a malformative process in an earlier stage of gestation. 7 This controversy on the pathogenesis of JIA arises partly because the clinical observations obtained from operative findings in neonates with JIA mostly show late local vascular events such as volvulus, hernia, constriction, and intussusception. These late disruptive events could not explain well the development of membranous type of atresia, APA, or MA.…”

“…Some reports have suggested that jejunal atresia including APA and MA may be a different disease from other jejunoileal atresia in terms of pathogenesis, clinical findings, and outcomes. 7,8 The fetus is connected with the placenta through the umbilical cord (UC) during gestation. Therefore, not only fetal but also placental or umbilical vascular compromises might play a role in the development of JIA.…”

Bishop Koop Technique is Preferred than Primary Anastomosis in Managing Jejunoileal Atresia in a Setup without Neonatal Intensive Care Unit - Our Initial Experience

“…Cause of early death in these infants is infection related to pneumonia, peritonitis, or sepsis 13 and the most significant postoperative complication following anastomosis include functional intestinal obstruction at the site of anastomosis and anastomotic leak 13,14 ; which is the common cause of mortality following surgery 14 . In the past survival rate was low 13 -58% to 75% but in recent years overall survival rate improved ranging from 80% to 90% or, more 15,16,17,18 due to NICU support with TPN. Our centre is handling these patients for more than a decade without NICU and TPN facility but overall outcome following resection anastomosis is hopeless in regard to complications and survival rate.…”